Mobile Sexual Health Unit for rural and remote communities

Our mobile outreach team in Papua New Guinea, community educator explaining contraception and vasectomy to people living in the highlands.

Explain your project idea (2,000 characters)

In rural and remote Australia, teenage pregnancy rates have not been declining; they have been increasing, and the further you go out, the higher they go. Likewise, sexually transmitted infections are much more common in rural Australia. The reasons are complex and multifarious and have a lot to do with education, economic opportunity and the effect of substance abuse. But access to culturally appropriate, quality, local services remains illusive to much of Australia's more remote areas, and the tyranny of distance cannot be ignored as an important factor that underwrites the effects of social disadvantage.

By breaking the cycle of pregnancy and burden of disease caused by late diagnosis and treatment of STIs, the bridge to peace and prosperity is paved by better sex and reproductive health education, and trusted and discrete services, when and where people need them most.

'Hub and spoke' models of care, where mobile health services perform outreach to supplement a central medical facility, are more appropriate and cost-effective than traditional health service delivery models in countries like Australia. In fact, some studies suggest that these mobile services can be delivered for as much as a quarter of the cost, whilst giving remote-living people more reliable and culturally appropriate services.

If you take into account the fact than many regional hospitals may only have a single surgical theatre and a fly-in surgeon, and will prioritise primary care, rather than sexual and reproductive health (as is the case across the country), then a mobile surgical unit could also provide important overflow to regional hospital services, which act as a base for mobile outreach.

With practitioners of both genders on a scheduled rotation of communities, with back up support from flying ambulance services, a mobile surgical unit focussed on this much neglected and stigmatised area of healthcare, could have significant impact on health outcomes in our regions.

Who are the beneficiaries? (1,000 characters)

In 2012, Marie Stopes International Australia received government funding to launch Snake Condoms, Australia's first and only Indigenous-friendly, socially marketed condom brand. We imagine this surgical unit would have the flair of Snake Bus.

Our beneficiaries are women and men of reproductive age, living in communities in and around northern Western Australia. In this region the Syphilis infection rate has more than doubled in the last 5 years; while teenage birth rates are twice what they are in Western Australia's metropolitan areas, posing increased risks for both mother and child in terms of their short and long term health, social and economic outcomes.

How is your idea unique? (1,000 characters)

The focus on surgical options is an important one, making it possible to deliver simple gynaecological procedures and vasectomies in situ, in culturally appropriate ways that improve uptake of services. The capacity to absorb overflow demand for regional hospitals is also an important part of the cost-effectiveness of the model.

Idea Proposal Stage (choose one)

Initial Design: I am exploring the idea, gathering the inspiration and information I need to test it with real users.

Tell us more about your organization/company (1 sentence and website URL)

Expertise in sector

7+ years

Organization Filing Status

Yes, we are a registered non-profit.

In 3-4 sentences, tell us the inspiration or story that encouraged you to start this project.

When you work in family planning you see the face of unmet need in women who present but cannot afford reliable contraception; in the face of those who have to travel vast distances to get the care they need, with little support; or in the stories of those who have not received the quality of care they deserve. Though they may feel they cannot share their stories publicly, or that sharing them will not have an impact; that does not mean we should stop trying to find solutions.

Please explain how your selected topic areas are influenced, in the local context of your project (1,000 characters).

Access to sex education and contraception are directly linked to the empowerment of women and their ability to help their families and communities prosper in peace. Australia has a big issue with domestic and family violence, and reproductive coercion. While research into this area is still relatively new, it would appear the additional barriers to access in non-urban areas compounds the effects of intimate partner violence, leading to poorer health outcomes for women in regional and remote areas (Marie Stopes Australia, 2018, 'Hidden Forces: shining a light on reproductive coercion.' Draft White Paper For Comment, June 2018).

Who will work alongside your organization in the project idea? (1,000 characters)

Given the investment, recruitment and training involved in setting up the mobile surgical unit, this project idea will require the support and guidance of program partners such as the state government, regional hospitals, emergency services, and community health groups.

Please share some of the top strengths identified in the community which your project will serve (500 characters)

Resourcefulness, resilience and a willingness of partnering organisations to address the issues.

Geographic Focus

We propose a trial region along Western Australia's hospital trail from Broome to Kununurra.

How many months are required for the project idea? (500 characters)

With funding and partnership support the trial could be establish after 12 months of planning, with 12 months to conduct and measure impact at a minimum. Ideally, however, it would be helpful to have 2 years from implementation to assess the project, so the full 36 month timeline.

Did you submit this idea to our 2017 BridgeBuilder Challenge? (Y/N)

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2comments

Congratulations on your idea, it looks very promising! We are doing work on comprehensive sexuality education in Africa. I was wondering why you target group does not include younger people, ie children between 6-14, as this may be the age that you can start teaching them about SRHR, which may contribute to lesser teenage pregnancies, better informed decisions etc. Is this something children learn in school in those areas?All the best,Lara

Thanks Lara, we really appreciate your engagement and your question! Sex education does occur as part of the school curriculum to an extent, and education could certainly form a part of the outreach - that's certainly not something we would omit (i.e. via forming partnerships through service delivery). But even here the idea is to offer sex education under the prism of better access to actual services. Hand in hand. However, your question has highlighted that we could have made that additional opportunity more obvious in our contribution. Thanks again for your question, Eleonore.